CMS Price Transparency Data

Digestive disorders treatment (inpatient stay)

Facility: Westchester Medical Center

Billing Code: 392 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 392
Insurance Median: $18,372
Cash Discount Price: $42,856
vs. Medicare Baseline: 3.24x Medicare

The contracted insurance negotiated median rate for a Digestive disorders treatment (inpatient stay) at Westchester Medical Center is $18,372. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $42,856. Compared to the federal Medicare reimbursement reference rate of $5,675.87, this hospital’s rate is 3.24x the Medicare baseline. Located in 100 Woods Rd, Valhalla, NY.

Cash / Self-Pay

$42,856

Average discount available for prompt cash payment at this facility.

Insurance Median

$18,372

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$5,675.87

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $5,675.87 (100%)

Cash / Self-Pay: $42,856 (755%)

Insurance Median: $18,372 (324%)

Cash: $42,856 (755% of Medicare)

Ins. Median: $18,372 (324% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $5,675.87 as the cost baseline. Rates below the baseline represent excellent value. In-network commercial rates commonly hover around 150% - 250% of Medicare, while rates exceeding 300% are elevated. Hover over the green and blue markers to view detailed calculations.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 324% of the Medicare baseline (a markup of 224%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance Rate (%)

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group	Contract Rate Range	vs. Medicare Reference
Value Options	$1,523 - $1,539	27%
Va	$6,120	108%
Cdphp	$8,608 - $40,174	152%
Aetna	$8,743 - $35,953	154%
Blue Cross Blue Shield	$8,743 - $41,207	154%
Cigna	$8,743 - $39,279	154%
Emblem	$8,743 - $39,894	154%
Health First	$8,743	154%
Magnacare	$8,743 - $49,857	154%
Mvp	$8,743 - $33,835	154%
Non Contracted	$8,743	154%
Oxford	$8,743 - $32,595	154%
Partners Health Plan	$8,743	154%
Todays Options	$8,743	154%
UnitedHealthcare	$8,743 - $32,595	154%
Wellcare	$8,743 - $16,175	154%
Oscar	$9,005	159%
Vns Choice	$9,005	159%
Molina	$9,180	162%
Tricare	$9,822	173%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $42,856.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify MS-DRG Code matches exactly: 392.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Westchester Medical Center is fully in-network.
Ask your insurer if "Prior Authorization" is required for MS-DRG code 392.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.